scholarly journals Thin endometrium and cleavage embryo transfer are associated with ectopic pregnancy after in vitro fertilization‑embryo transfer cycles: a matched case–control study using propensity score matching

Author(s):  
Ying Zhao ◽  
Dong'e Liu ◽  
Nenghui Liu ◽  
Yumei Li ◽  
Zhongyuan Yao ◽  
...  

Abstract Objective: To evaluate the relationship between the endometrial features (endometrial thickness(EMT), pattern and endometrium growth amplitude and rate) and the embryo stage transferred and ectopic pregnancy after IVF-ET based on the data of 628 matched cases. Methods: This was a 1:1 matched case-control study that enrolled 314 EP patients and 314 matched IUP patients from the ART center of Xiangya Hospital of Central South University from January 2014 to April 2020. Univariate analysis and multiple-stepwise logistic regression analysis was used to analyze the risk factors of EP, and a receiver-operating characteristic (ROC) curve was generated to predict EP. Results: 1. The EP group had a higher cleavage stage embryo transfer rate(94.57% vs 86.22%), a thinner endometrium on transformation day (the day when progesterone was added in the frozen embryo cycle or the trigger day in the fresh embryo cycle) (9.40(2.60) mm vs 9.80(2.60)mm) compared with IUP group. In fresh embryo cycles, the EP group had a higher endometrium pattern C proportion on transformation day, a smaller endometrium increment, and a slower endometrial growth rate compared with the IUP group. 2.The ROC curves were used to analyze the cut-off values of the EMT on transformation day, the endometrial growth amplitude and rate in fresh cycles, the results were 9.35mm, 4.90mm and 0.491 mm/d, respectively. The incidence of EP was significantly different between groups according to cut-off values. 3. The transferred embryo stage and EMT on transformation day were independent factors affecting outcome in the general population. The area under the curve(AUC) of the EMT and the stage of embryos transferred for EP prediction was 0.604, sensitivity was 0.702, and specificity was 0.465. The EMT on trigger day was an independent factor affecting outcome in the fresh cycles. The AUC of the EMT for EP prediction in fresh cycles was 0.605, sensitivity was 0.805, and specificity was 0.420. Conclusions: 1. Transferring cleavage stage embryo , and thin EMT on the transformation day were risk factors for EP. 2. Thin EMT and pattern C on transformation day may be related to abnormal endometrial receptivity and endometrial peristaltic waves. 3.The combined indicator of EMT and embryonic development stage could not well predict the occurrence of EP after ET.

2021 ◽  
Author(s):  
Ying Zhao ◽  
Dong'e Liu ◽  
Nenghui Liu ◽  
Yumei Li ◽  
Zhongyuan Yao ◽  
...  

Abstract Objective: To evaluate the relationship between the endometrial features (endometrial thickness(EMT), pattern and endometrium growth amplitude and rate) and the embryo stage transferred and ectopic pregnancy after IVF-ET based on the data of 628 matched cases. Methods: This was a 1:1 matched case-control study that enrolled 314 EP patients and 314 matched IUP patients from the ART center of Xiangya Hospital of Central South University from January 2014 to April 2020. Univariate analysis and multiple-stepwise logistic regression analysis was used to analyze the risk factors of EP, and a receiver-operating characteristic (ROC) curve was generated to predict EP. Results: 1. The EP group had a higher cleavage stage embryo transfer rate(94.57% vs 86.22%), a thinner endometrium on transformation day(the day when progesterone was added in the frozen embryo cycle or the trigger day in the fresh embryo cycle) (9.40(2.60) mm vs 9.80(2.60)mm) compared with IUP group. In fresh embryo cycles, the EP group had a higher endometrium pattern C proportion on transformation day, a smaller endometrium increment, and a slower endometrial growth rate compared with the IUP group. 2.The ROC curves were used to analyze the cut-off values of the EMT on transformation day, the endometrial growth amplitude and rate in fresh cycles, the results were 9.35mm, 4.90mm and 0.491 mm/d, respectively. The incidence of EP was significantly different between groups according to cut-off values. 3.The transferred embryo stage and EMT on transformation day were independent factors affecting outcome in the general population. The area under the curve(AUC) of the EMT and the stage of embryos transferred for EP prediction was 0.604, sensitivity was 0.702, and specificity was 0.465. The EMT on trigger day was an independent factor affecting outcome in the fresh cycles. The AUC of the EMT for EP prediction in fresh cycles was 0.605, sensitivity was 0.805, and specificity was 0.420. Conclusions: 1. Transferring cleavage stage embryo, and thin EMT on the transformation day were risk factors for EP. 2. Thin EMT and pattern C on transformation day may be related to abnormal endometrial receptivity and endometrial peristaltic waves. 3.The combined indicator of EMT and embryonic development stage could not well predict the occurrence of EP after ET.


2021 ◽  
pp. 1-26
Author(s):  
Xue-min Huang ◽  
Yan-hua Liu ◽  
Han Zhang ◽  
Yuan Cao ◽  
Wei-feng Dou ◽  
...  

Abstract The effect of vitamin D (VD) on the risk of preeclampsia (PE) is uncertain. Few of previous studies focused on the relationship between dietary VD intake and PE risk. Therefore, we conducted this 1:1 matched case-control study to explore the association of dietary VD intake and serum VD concentrations with PE risk in Chinese pregnant women. A total of 440 pairs of participants were recruited during March 2016 to June 2019. Dietary information was obtained using a 78-item semi-quantitative food frequency questionnaire. Serum concentrations of 25(OH)D2 and 25(OH)D3 were measured by liquid chromatography–tandem mass spectrometry. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines (RCS) were plotted to evaluate the dose-response relationship of dietary VD intake and serum VD concentrations with PE risk. Compared with the lowest quartile, the ORs of the highest quartile were 0.45 (95%CI: 0.29-0.71, Ptrend = 0.001) for VD dietary intake and 0.26 (95%CI: 0.11-0.60, Ptrend = 0.003) for serum levels after adjusting for confounders. In addition, the RCS analysis suggested a reverse J-shaped relationship between dietary VD intake and PE risk (P-nonlinearity = 0.02). A similar association was also found between serum concentrations of total 25(OH)D and PE risk (P-nonlinearity = 0.02). In conclusion, this study provides evidence that higher dietary intake and serum levels of VD are associated with the lower risk of PE in Chinese pregnant women.


Sign in / Sign up

Export Citation Format

Share Document